Thrombophilia screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Asiri Ediriwickrema, M.D., M.H.S. [2]
Overview
- Screening for thrombophilia depends on the clinical presentation.
- Screening should be avoided in the setting of major transient risk factors.
Screening
- The American Society of Hematology recommends against thrombophilia screening in adult patients with venous thrombosis in the setting of major transient risk factors which include surgery, trauma, or prolonged immobility.[1]
- However, given the associated risks for recurrent thrombosis, patients who have significant risk factors including a positive family history or concurrent treatment with hormonal therapies should seek expert consultation.
- Therefore, screening may be useful in the following situations.[2]
- Asymptomatic screening: First degree relatives of patients with homozygosity for factor V leiden, antithrombin deficiency, protein C or S deficiency and anticipated hormone therapy or pregnancy.
- Syptomatic screening (patients with acute thrombus) may be useful in patients with certain clinical presentations.
- Screening can be expensive, and are often performed at inappropriate times.
- Refer to thrombophilia laboratory findings for more information on specific screening tests.
References
- ↑ Hicks LK, Bering H, Carson KR, Kleinerman J, Kukreti V, Ma A; et al. (2013). "The ASH Choosing Wisely®campaign: five hematologic tests and treatments to question". Hematology Am Soc Hematol Educ Program. 2013: 9–14. doi:10.1182/asheducation-2013.1.9. PMID 24319155.
- ↑ Middeldorp S (2011). "Evidence-based approach to thrombophilia testing". J Thromb Thrombolysis. 31 (3): 275–81. doi:10.1007/s11239-011-0572-y. PMC 3056012. PMID 21340752.